Cardioprotective Effects of Glucose and Insulin Administration While Maintaining Normoglycemia (GIN Therapy) in Patients Undergoing Coronary Artery Bypass Grafting
| العنوان: | Cardioprotective Effects of Glucose and Insulin Administration While Maintaining Normoglycemia (GIN Therapy) in Patients Undergoing Coronary Artery Bypass Grafting |
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| المؤلفون: | Hiroaki Sato, André Marette, Thomas Schricker, Patricia Pelletier, Ralph Lattermann, George Carvalho, Kevin Lachapelle, Roupen Hatzakorzian, Turki B. Albacker, Denis R. Joanisse |
| المصدر: | The Journal of Clinical Endocrinology & Metabolism. 96:1469-1477 |
| بيانات النشر: | The Endocrine Society, 2011. |
| سنة النشر: | 2011 |
| مصطلحات موضوعية: | Blood Glucose, Male, endocrine system diseases, Biopsy, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Clinical Biochemistry, Biochemistry, Coronary artery bypass surgery, Postoperative Complications, Endocrinology, Myocardial Revascularization, Insulin, Medicine, Anesthesia, Coronary Artery Bypass, Middle Aged, Glucose clamp technique, Oncogene Protein v-akt, Glycogen Synthase, Treatment Outcome, medicine.anatomical_structure, Echocardiography, Female, Glycogen, Artery, medicine.medical_specialty, Cardiotonic Agents, Ischemia, Myocardial Reperfusion Injury, Internal medicine, Humans, Hypoglycemic Agents, Cardioprotective Agent, cardiovascular diseases, Muscle, Skeletal, Aged, business.industry, Biochemistry (medical), nutritional and metabolic diseases, AMPK, medicine.disease, Cyclic AMP-Dependent Protein Kinases, Glucose, Glucose Clamp Technique, Energy Metabolism, Troponin C, business, Reperfusion injury |
| الوصف: | Coronary artery bypass grafting (CABG) is complicated by ischemia-reperfusion injury jeopardizing myocyte survival.The aim of the study was to investigate whether glucose and insulin administration, while maintaining normoglycemia (GIN therapy) using a hyperinsulinemic-normoglycemic clamp technique, is cardioprotective in patients undergoing CABG.We conducted a randomized controlled trial at a tertiary care university teaching hospital.We studied 99 patients undergoing elective CABG.Patients were randomly assigned to receive either GIN from the beginning of surgery until 24 h after CABG (GIN, n = 49) or standard metabolic care (control, n = 50).We measured plasma concentrations of cardiac troponin I and free fatty acids, cardiac function as assessed by transesophageal echocardiography, glycogen content, glycogen synthase activity, and the expression of AMP-activated protein kinase (AMPK) and protein kinase B (AKT) in cardiomyocytes.Patients receiving GIN therapy showed an attenuated release of cardiac troponin I (P0.05) and improved myocardial function (P0.05). Systemic free fatty acid concentrations were suppressed (P0.05), whereas intracellular glycogen content and glycogen synthase activity were not altered. The AMPK activity remained unchanged during ischemia in the GIN group, whereas it increased in the control group (P0.05). Enhanced AKT phosphorylation before ischemia was observed (P0.05) in the presence of GIN. However, there was no evidence for AKT-dependent AMPK inhibition.GIN therapy protects the myocardium and inhibits ischemia-induced AMPK activation. |
| تدمد: | 1945-7197 0021-972X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b21574fb424a34ddce5899c22329234aTest https://doi.org/10.1210/jc.2010-1934Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....b21574fb424a34ddce5899c22329234a |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19457197 0021972X |
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